One hears a great deal about assisted suicide, so one would naturally think that it is a common practice taking place throughout the world. This is not the case. Legislation permitting assisted suicide has only been passed in six countries – the Netherlands, Belgium, Luxemburg, Switzerland, Colombia, Canada, and also in eight American states and one Australian state.
The rest of the globe has not been as quick to allow this procedure. There are too many unanswered questions about it. For example, in April, 2020, the U.K.’s Lord Chancellor Robert Buckland QC advised Parliament’s Joint Committee on Human Rights that the government has no plans to review the law on assisted suicide. Mr. Buckland stated that there are “grave doubts about the efficacy of drafting a law that would prevent the sort of unintended consequences and abuses that none of us would want to see happen.” Although the U.S. state of Oregon has permitted assisted suicide for 18 years, there are disturbing, unanswered gaps in knowledge about the application of this law. There are also concerns in other countries about the following:
- There are no legally required reporting procedures in some jurisdictions, and in others, mentioning “medical aid in dying” on a death certificate is forbidden.
- There is an underreporting bias. For example, even seven years after assisted suicide legislation in the Netherlands, one fifth of the deaths from assisted suicide are not reported and, in Belgium, one third of the cases are not reported.
- Current research has been limited to interviewing or surveying only the physicians involved in the process, who obviously have a bias in support of the procedure. In-depth knowledge, especially concerning vulnerable population groups, such as the aged and those suffering from severe mental illness or physical disabilities, has not been obtained, nor have the views of patients’ relatives been sought.
- There has been little research on the link between assisted suicide, palliative care and quality of care. In short, what is the influence of assisted suicide on palliative care practice?
- There has been no study in regard to the pressure that has been placed on people requesting euthanasia. Did they agree to assisted suicide because of their feelings of being a burden on their relatives and society in order to resolve others’ problems, rather than others providing better solutions for them?
- There has been no in-depth examination of the impact of assisted suicide on the deceased’s relatives.
In view of these unanswered questions, it comes as no surprise that, in 2018, the World Medical Association (WMA) reaffirmed its long-standing policy of opposition to euthanasia and physician-assisted suicide. This was again affirmed in October 2019. The WMA also strongly supports conscientious objections by physicians from participating in these procedures, and objects to physicians being required to make referrals for this procedure. At the WMA meeting in 2018 which had affirmed the official opposition to assisted suicide, the Canadian delegation at the meeting, ever progressive, together with the Dutch delegation, tried to change the organization’s stance on the issue. When they failed, Canada pulled out of the WMA.
The WMA statement coincided with another statement, this time from a religious perspective. Representatives of the three Abrahamic religions – Christians, Jews, and Muslims – signed a declaration at the Vatican repudiating euthanasia and assisted suicide. The statement also stressed the importance of palliative care and the importance of assuring patients that they are valuable, with human dignity, and therefore cannot be regarded as “useless” at the end of their lives.
The Trudeau Government’s Treatment of Assisted Suicide
The Trudeau government is scrambling to widen its legislation on assisted suicide, which was passed in June 2016. This legislation called Medical Assistance in Dying (MAID) has resulted in 15,000 deaths in Canada by assisted suicide.
The government has now tabled an extension to assisted suicide (Bill C-7), which will make it available to those who are not necessarily dying. It also removes the ten-day reflection period between a person’s request for euthanasia or assisted suicide and the day it’s carried out. This would mean a person’s life can be ended on the same day he/she makes the request for assisted suicide. Another safeguard to be removed under Bill C-7 is that it would no longer require consent be reaffirmed at the time of euthanasia, but would allow for a waiver of final consent for people who have previously been approved for euthanasia but have lost their capacity to consent. There already have been instances under current legislation when there have been long delays between providing consent and the procedure being put into effect.
By eliminating “terminal illness” in the legislation, Bill C-7 proposes to expand euthanasia to allow those with psychological conditions only, to receive assisted suicide, since the new legislation states the person qualifies for euthanasia “if the illness, disease or disability or the state of decline causes them…psychological suffering that is intolerable to them and cannot be relieved under conditions that they consider acceptable” (emphasis ours). What exactly is “psychological suffering”? Can it include patients suffering from diabetes, arthritis or schizophrenia, for example, even though these conditions are treatable? Such patients’ medical problems may well cause some psychological suffering and may cause them to decide at some low point in their lives that they should allow themselves to consent to death. These amendments, proposed in Bill C-7, if passed, will make Canada’s euthanasia law the most permissive in the world.
Not content with the removal of the above-mentioned safeguards, the Trudeau government is further reviewing the possibility of extending assisted suicide to include minor children and the mentally ill, who may well be incapable of providing their consent.
In his haste and obsession with being a “progressive” leader in the world, Trudeau’s legislation on assisted suicide is endangering human lives, causing deep division in the medical profession, and appears to be dramatically out of step with most of the rest of the world.